Medical monitoring hub

ABSTRACT

The present disclosure includes a medical monitoring hub as the center of monitoring for a monitored patient. The hub includes configurable medical ports and serial ports for communicating with other medical devices in the patient&#39;s proximity. Moreover, the hub communicates with a portable patient monitor. The monitor, when docked with the hub provides display graphics different from when undocked, the display graphics including anatomical information. The hub assembles the often vast amount of electronic medical data, associates it with the monitored patient, and in some embodiments, communicates the data to the patient&#39;s medical records.

PRIORITY CLAIM AND RELATED APPLICATIONS

This application is a continuation of U.S. patent application Ser. No.15/968,392, filed May 1, 2018, and titled “Medical Monitoring Hub,”which application is a continuation of U.S. patent application Ser. No.15/214,156, filed Jul. 19, 2016, and titled “Medical Monitoring Hub,”which application is a divisional of U.S. patent application Ser. No.13/651,167, filed Oct. 12, 2012, and titled “Medical Monitoring Hub,”which application claims a priority benefit under 35 U.S.C. § 119 to thefollowing U.S. Provisional Patent applications:

Ser. No. Date Title 61/547,017, Oct. 13, 2011, Visual Correlation ofPhysiological Information, 61/547,577, Oct. 14, 2011, Visual Correlationof Physiological Information, 61/597,120, Feb. 9, 2012, VisualCorrelation of Physiological Information, and. 61/703,773 Sep. 20, 2012Medical Monitoring Hub

Each of the foregoing disclosures is incorporated by reference herein inits entirety.

FIELD OF THE DISCLOSURE

The present disclosure relates generally to patient monitoring devicesand specifically to a patient monitor and medical data communicationhub.

BACKGROUND OF THE DISCLOSURE

Today's patient monitoring environments are crowded with sophisticatedand often electronic medical devices servicing a wide variety ofmonitoring and treatment endeavors for a given patient. Generally, manyif not all of the devices are from differing manufactures, and many maybe portable devices. The devices may not communicate with one anotherand each may include its own control, display, alarms, configurationsand the like. Complicating matters, caregivers often desire to associateall types of measurement and use data from these devices to a specificpatient. Thus, patient information entry often occurs at each device.Sometimes, the disparity in devices leads to a need to simply print andstore paper from each device in a patient's file for caregiver review.

The result of such device disparity is often a caregiver environmentscattered with multiple displays and alarms leading to a potentiallychaotic experience. Such chaos can be detrimental to the patient in manysituations including surgical environments where caregiver distractionis unwanted, and including recovery or monitoring environments wherepatient distraction or disturbance may be unwanted.

Various manufacturers produce multi-monitor devices or devices thatmodularly expand to increase the variety of monitoring or treatmentendeavors a particular system can accomplish. However, as medical devicetechnology expands, such multi-monitor devices begin to be obsolete themoment they are installed.

SUMMARY OF THE INVENTION

Based on at least the foregoing, a solution is needed that coordinatesthe various medical devices treating or monitoring a patient.Embodiments of such a solution should provide patient identificationseamlessly across the device space and embodiments of such a solutionshould expand for future technologies without necessarily requiringrepeated software upgrades. In addition, embodiments of such a solutionmay include patient electrical isolation where desired.

Therefore, the present disclosure relates to a patient monitoring hubthat is the center of patient monitoring and treatment activities for agiven patient. Embodiments of the patient monitoring hub interface withlegacy devices without necessitating legacy reprogramming, provideflexibility for interfacing with future devices without necessitatingsoftware upgrades, and offer optional patient electrical isolation. Inan embodiment, the hub includes a large display dynamically providinginformation to a caregiver about a wide variety of measurement orotherwise determined parameters. Additionally, in an embodiment, the hubincludes a docking station for a portable patient monitor. The portablepatient monitor may communicate with the hub through the docking stationor through various wireless paradigms known to an artisan from thedisclosure herein, including WiFi, Bluetooth, Zigbee, or the like.

In still other embodiments, the portable patient monitor modifies itsscreen when docked. The undocked display indicia is in part or in wholetransferred to a large dynamic display of the hub and the docked displaypresents one or more anatomical graphics of monitored body parts. Forexample, the display may present a heart, lungs, a brain, kidneys,intestines, a stomach, other organs, digits, gastrointestinal systems orother body parts when it is docked. In an embodiment, the anatomicalgraphics may advantageously be animated. In an embodiment, the animationmay generally follow the behavior of measured parameters, such as, forexample, the lungs may inflate in approximate correlation to themeasured respiration rate and/or the determined inspiration portion of arespiration cycle, and likewise deflate according to the expirationportion of the same. The heart may beat according to the pulse rate, maybeat generally along understood actual heart contraction patterns, andthe like. Moreover, in an embodiment, when the measured parametersindicate a need to alert a caregiver, a changing severity in color maybe associated with one or more displayed graphics, such as the heart,lungs, brain, or the like. In still other embodiments, the body portionsmay include animations on where, when or how to attach measurementdevices to measurement sites on the patient. For example, the monitormay provide animated directions for CCHD screening procedures or glucosestrip reading protocols, the application of a forehead sensor, a fingeror toe sensor, one or more electrodes, an acoustic sensor, and earsensor, a cannula sensor or the like.

For purposes of summarizing the disclosure, certain aspects, advantagesand novel features are discussed herein. It is to be understood that notnecessarily all such aspects, advantages or features will be embodied inany particular embodiment of the invention and an artisan wouldrecognize from the disclosure herein a myriad of combinations of suchaspects, advantages or features.

BRIEF DESCRIPTION OF THE DRAWINGS

The following drawings and the associated descriptions are provided toillustrate embodiments of the present disclosure and do not limit thescope of the claims.

FIGS. 1A-1C illustrate perspective views of an exemplary medicalmonitoring hub according to an embodiment of the disclosure. Forexample, FIG. 1A illustrates the hub with an exemplary docked portablepatient monitor, FIG. 1B illustrates the hub with a set of medical portsand a noninvasive blood pressure input, and FIG. 1C illustrates the hubwith various exemplary temperature sensors attached thereto, allaccording to various embodiments of the disclosure.

FIG. 2 illustrates a simplified block diagram of an exemplary monitoringenvironment including the hub of FIG. 1, according to an embodiment ofthe disclosure.

FIG. 3 illustrates a simplified exemplary hardware block diagram of thehub of FIG. 1, according to an embodiment of the disclosure.

FIG. 4 illustrates a perspective view of an exemplary removable dockingstation of the hub of FIG. 1, according to an embodiment of thedisclosure.

FIG. 5 illustrates a perspective view of exemplary portable patientmonitors undocked from the hub of FIG. 1, according to an embodiment ofthe disclosure. Moreover, FIG. 5 illustrates an exemplary alternativedocking station.

FIG. 6 illustrates a simplified block diagram of traditional patientdevice electrical isolation principles.

FIG. 7A illustrates a simplified block diagram of an exemplary optionalpatient device isolation system according to an embodiment of thedisclosure, while FIG. 7B adds exemplary optional non-isolation powerlevels for the system of FIG. 7A, also according to an embodiment of thedisclosure.

FIG. 8 illustrates a simplified exemplary universal medical connectorconfiguration process, according to an embodiment of the disclosure.

FIGS. 9A-9B illustrate simplified block diagrams of exemplary universalmedical connectors having a size and shape smaller in cross section thantradition isolation requirements.

FIG. 10 illustrates a perspective view of a side of the hub of FIG. 1,showing exemplary instrument-side channel inputs for exemplary universalmedical connectors, according to an embodiment of the disclosure.

FIGS. 11A-11K illustrate various views of exemplary male and matingfemale universal medical connectors, according to embodiments of thedisclosure.

FIG. 12 illustrates a simplified block diagram of a channel system forthe hub of FIG. 1, according to an embodiment of the disclosure.

FIG. 13 illustrates an exemplary logical channel configuration,according to an embodiment of the disclosure.

FIG. 14 illustrates a simplified exemplary process for constructing acable and configuring a channel according to an embodiment of thedisclosure.

FIG. 15 illustrates a perspective view of the hub of FIG. 1, includingan exemplary attached board-in-cable to form an input channel, accordingto an embodiment of the disclosure.

FIG. 16 illustrates a perspective view of a back side of the hub of FIG.1, showing an exemplary instrument-side serial data inputs, according toan embodiment of the disclosure.

FIG. 17A illustrates an exemplary monitoring environment withcommunication through the serial data connections of FIG. 16, and FIG.17B illustrates an exemplary connectivity display of the hub of FIG. 1,according to embodiments of the disclosure.

FIG. 18 illustrates a simplified exemplary patient data flow process,according to an embodiment of the disclosure.

FIGS. 19A-19J illustrate exemplary displays of anatomical graphics forthe portable patient monitor of FIG. 1 docked with the hub of FIG. 1,according to embodiments of the disclosure.

FIGS. 20A-20C illustrate exemplary displays of measurement data showingdata separation and data overlap on a display of the hub of FIG. 1,respectively, according embodiments of the disclosure.

FIGS. 21A and 21B illustrate exemplary displays of measurement datashowing data separation and data overlap on a display of the portablepatient monitor of FIG. 1, respectively, according embodiments of thedisclosure.

FIGS. 22A and 22B illustrate exemplary analog display indicia accordingto an embodiment of the disclosure.

FIGS. 23A-23F illustrate exemplary displays of measurement data showing,for example, data presentation in FIGS. 23A-23D when a depth ofconsciousness monitor is connected to a channel port of the hub of FIG.1, data presentation in FIG. 23E when temperature and blood pressuresensors communicate with the hub of FIG. 1 and data presentation in FIG.23F when an acoustic sensor is also communicating with the hub of FIG.1, according embodiments of the disclosure.

While the foregoing “Brief Description of the Drawings” referencesgenerally various embodiments of the disclosure, an artisan willrecognize from the disclosure herein that such embodiments are notmutually exclusive. Rather, the artisan would recognize a myriad ofcombinations of some or all of such embodiments.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT

The present disclosure relates to a medical monitoring hub configured tobe the center of monitoring activity for a given patient. In anembodiment, the hub comprises a large easily readable display, such asan about ten (10) inch display dominating the majority of real estate ona front face of the hub. The display could be much larger or muchsmaller depending upon design constraints. However, for portability andcurrent design goals, the preferred display is roughly sizedproportional to the vertical footprint of one of the dockable portablepatient monitors. Other considerations are recognizable from thedisclosure herein by those in the art.

The display provides measurement data for a wide variety of monitoredparameters for the patient under observation in numerical or graphicform, and in various embodiments, is automatically configured based onthe type of data and information being received at the hub. In anembodiment, the hub is moveable, portable, and mountable so that it canbe positioned to convenient areas within a caregiver environment. Forexample, the hub is collected within a singular housing.

In an embodiment, the hub may advantageously receive data from aportable patient monitor while docked or undocked from the hub. Typicalportable patient monitors, such as oximeters or co-oximeters can providemeasurement data for a large number of physiological parameters derivedfrom signals output from optical and/or acoustic sensors, electrodes, orthe like. The physiological parameters include, but not limited tooxygen saturation, carboxy hemoglobin, methemoglobin, total hemoglobin,glucose, pH, bilirubin, fractional saturation, pulse rate, respirationrate, components of a respiration cycle, indications of perfusionincluding perfusion index, signal quality and/or confidences,plethysmograph data, indications of wellness or wellness indexes orother combinations of measurement data, audio information responsive torespiration, ailment identification or diagnosis, blood pressure,patient and/or measurement site temperature, depth of sedation, organ orbrain oxygenation, hydration, measurements responsive to metabolism,combinations of the same or the like, to name a few. In otherembodiments, the hub may output data sufficient to accomplishclosed-loop drug administration in combination with infusion pumps orthe like.

In an embodiment, the hub communicates with other devices in amonitoring environment that are interacting with the patient in a numberof ways. For example, the hub advantageously receives serial data fromother devices without necessitating their reprogramming or that of thehub. Such other devices include pumps, ventilators, all manner ofmonitors monitoring any combination of the foregoing parameters,ECG/EEG/EKG devices, electronic patient beds, and the like. Moreover,the hub advantageously receives channel data from other medical deviceswithout necessitating their reprogramming or that of the hub. When adevice communicates through channel data, the hub may advantageouslyalter the large display to include measurement information from thatdevice. Additionally, the hub accesses nurse call systems to ensure thatnurse call situations from the device are passed to the appropriatenurse call system.

The hub also communicates with hospital systems to advantageouslyassociate incoming patient measurement and treatment data with thepatient being monitored. For example, the hub may communicate wirelesslyor otherwise to a multi-patient monitoring system, such as a server orcollection of servers, which in turn many communicate with a caregiver'sdata management systems, such as, for example, an Admit, Discharge,Transfer (“ADT”) system and/or an Electronic Medical Records (“EMR”)system. The hub advantageously associates the data flowing through itwith the patient being monitored thereby providing the electronicmeasurement and treatment information to be passed to the caregiver'sdata management systems without the caregiver associating each device inthe environment with the patient.

In an embodiment, the hub advantageously includes a reconfigurable andremovable docking station. The docking station may dock additionallayered docking stations to adapt to different patient monitoringdevices. Additionally, the docking station itself is modularized so thatit may be removed if the primary dockable portable patient monitorchanges its form factor. Thus, the hub is flexible in how its dockingstation is configured.

In an embodiment, the hub includes a large memory for storing some orall of the data it receives, processes, and/or associates with thepatient, and/or communications it has with other devices and systems.Some or all of the memory may advantageously comprise removable SDmemory.

The hub communicates with other devices through at least (1) the dockingstation to acquire data from a portable monitor, (2) innovativeuniversal medical connectors to acquire channel data, (3) serial dataconnectors, such as RJ ports to acquire output data, (4) Ethernet, USB,and nurse call ports, (5) Wireless devices to acquire data from aportable monitor, (6) other wired or wireless communication mechanismsknown to an artisan. The universal medical connectors advantageouslyprovide optional electrically isolated power and communications, aredesigned to be smaller in cross section than isolation requirements. Theconnectors and the hub communicate to advantageously translate orconfigure data from other devices to be usable and displayable for thehub. In an embodiment, a software developers kit (“SDK”) is provided toa device manufacturer to establish or define the behavior and meaning ofthe data output from their device. When the output is defined, thedefinition is programmed into a memory residing in the cable side of theuniversal medical connector and supplied as an original equipmentmanufacture (“OEM”) to the device provider. When the cable is connectedbetween the device and the hub, the hub understands the data and can useit for display and processing purposes without necessitating softwareupgrades to the device or the hub. In an embodiment, the hub cannegotiate the schema and even add additional compression and/orencryption. Through the use of the universal medical connectors, the huborganizes the measurement and treatment data into a single display andalarm system effectively and efficiently bringing order to themonitoring environment.

As the hub receives and tracks data from other devices according to achannel paradigm, the hub may advantageously provide processing tocreate virtual channels of patient measurement or treatment data. In anembodiment, a virtual channel may comprise a non-measured parameter thatis, for example, the result of processing data from various measured orother parameters. An example of such a parameter includes a wellnessindicator derived from various measured parameters that give an overallindication of the wellbeing of the monitored patient. An example of awellness parameter is disclosed in U.S. patent application Ser. Nos.13/269,296, 13/371,767 and 12/904,925, by the assignee of the presentdisclosure and incorporated by reference herein. By organizing data intochannels and virtual channels, the hub may advantageously time-wisesynchronize incoming data and virtual channel data.

The hub also receives serial data through serial communication ports,such as RJ connectors. The serial data is associated with the monitoredpatient and passed on to the multi-patient server systems and/orcaregiver backend systems discussed above. Through receiving the serialdata, the caregiver advantageously associates devices in the caregiverenvironment, often from varied manufactures, with a particular patient,avoiding a need to have each individual device associated with thepatient and possible communicating with hospital systems. Suchassociation is vital as it reduces caregiver time spent enteringbiographic and demographic information into each device about thepatient. Moreover, in an embodiment, through the SDK the devicemanufacturer may advantageously provide information associated with anymeasurement delay of their device, thereby further allowing the hub toadvantageously time-wise synchronize serial incoming data and other dataassociated with the patient.

In an embodiment, when a portable patient monitor is docked, and itincludes its own display, the hub effectively increases its display realestate. For example, in an embodiment, the portable patient monitor maysimply continue to display its measurement and/or treatment data, whichmay be now duplicated on the hub display, or the docked display mayalter its display to provide additional information. In an embodiment,the docked display, when docked, presents anatomical graphical data of,for example, the heart, lungs, organs, the brain, or other body partsbeing measured and/or treated. The graphical data may advantageouslyanimate similar to and in concert with the measurement data. Forexample, lungs may inflate in approximate correlation to the measuredrespiration rate and/or the determined inspiration/expiration portionsof a respiration cycle, the heart may beat according to the pulse rate,may beat generally along understood actual heart contraction patterns,the brain may change color or activity based on varying depths ofsedation, or the like. In an embodiment, when the measured parametersindicate a need to alert a caregiver, a changing severity in color maybe associated with one or more displayed graphics, such as the heart,lungs, brain, organs, circulatory system or portions thereof,respiratory system or portions thereof, other body parts or the like. Instill other embodiments, the body portions may include animations onwhere, when or how to attach measurement devices.

The hub may also advantageously overlap parameter displays to provideadditional visual information to the caregiver. Such overlapping may beuser definable and configurable. The display may also incorporateanalog-appearing icons or graphical indicia.

In the interest of clarity, not all features of an actual implementationare described in this specification. An artisan will of course beappreciate that in the development of any such actual implementation (asin any development project), numerous implementation-specific decisionsmust be made to achieve a developers' specific goals and subgoals, suchas compliance with system- and business-related constraints, which willvary from one implementation to another. Moreover, it will beappreciated that such a development effort might be complex andtime-consuming, but would nevertheless be a routine undertaking ofdevice engineering for those of ordinary skill having the benefit ofthis disclosure.

To facilitate a complete understanding of the disclosure, the remainderof the detailed description describes the disclosure with reference tothe drawings, wherein like reference numbers are referenced with likenumerals throughout.

FIG. 1A illustrates a perspective view of an exemplary medicalmonitoring hub 100 with an exemplary docked portable patient monitor 102according to an embodiment of the disclosure. The hub 100 includes adisplay 104, and a docking station 106, which in an embodiment isconfigured to mechanically and electrically mate with the portablepatient monitor 102, each housed in a movable, mountable and portablehousing 108. The housing 108 includes a generally upright inclined shapeconfigured to rest on a horizontal flat surface, although the housing108 can be affixed in a wide variety of positions and mountings andcomprise a wide variety of shapes and sizes.

In an embodiment, the display 104 may present a wide variety ofmeasurement and/or treatment data in numerical, graphical, waveform, orother display indicia 110. In an embodiment, the display 104 occupiesmuch of a front face of the housing 108, although an artisan willappreciate the display 104 may comprise a tablet or tabletop horizontalconfiguration, a laptop-like configuration or the like. Otherembodiments may include communicating display information and data to atable computer, smartphone, television, or any display systemrecognizable to an artisan. The upright inclined configuration of FIG.1A presents display information to a caregiver in an easily viewablemanner.

FIG. 1B shows a perspective side view of an embodiment of the hub 100including the housing 108, the display 104, and the docking station 106without a portable monitor docked. Also shown is a connector fornoninvasive blood pressure.

In an embodiment, the housing 108 may also include pockets orindentations to hold additional medical devices, such as, for example, ablood pressure monitor or temperature sensor 112, such as that shown inFIG. 1C.

The portable patient monitor 102 of FIG. 1A may advantageously comprisean oximeter, co-oximeter, respiratory monitor, depth of sedationmonitor, noninvasive blood pressure monitor, vital signs monitor or thelike, such as those commercially available from Masimo Corporation ofIrvine, Calif., and/or disclosed in U.S. Pat. Pub. Nos. 2002/0140675,2010/0274099, 2011/0213273, 2012/0226117, 2010/0030040; U.S. Pat. App.Ser. Nos. 61/242,792, 61/387457, 61/645,570, 13/554,908 and U.S. Pat.Nos. 6,157,850, 6,334,065, and the like. The monitor 102 may communicatewith a variety of noninvasive and/or minimally invasive devices such asoptical sensors with light emission and detection circuitry, acousticsensors, devices that measure blood parameters from a finger prick,cuffs, ventilators, and the like. The monitor 102 may include its owndisplay 114 presenting its own display indicia 116, discussed below withreference to FIGS. 19A-19J. The display indicia may advantageouslychange based on a docking state of the monitor 102. When undocked, thedisplay indicia may include parameter information and may alterorientation based on, for example, a gravity sensor or accelerometer.

In an embodiment, the docking station 106 of the hub 100 includes amechanical latch 118, or mechanically releasable catch to ensure thatmovement of the hub 100 doesn't mechanically detach the monitor 102 in amanner that could damage the same.

Although disclosed with reference to particular portable patientmonitors 102, an artisan will recognize from the disclosure herein alarge number and wide variety of medical devices that may advantageouslydock with the hub 100. Moreover, the docking station 106 mayadvantageously electrically and not mechanically connect with themonitor 102, and/or wirelessly communicate with the same.

FIG. 2 illustrates a simplified block diagram of an exemplary monitoringenvironment 200 including the hub 100 of FIG. 1, according to anembodiment of the disclosure. As shown in FIG. 2, the environment mayinclude the portable patient monitor 102 communicating with one or morepatient sensors 202, such as, for example, oximetry optical sensors,acoustic sensors, blood pressure sensors, respiration sensors or thelike. In an embodiment, additional sensors, such as, for example, a NIBPsensor or system 211 and a temperature sensor or sensor system 213 maycommunicate directly with the hub 100. The sensors 202, 211 and 213 whenin use are typically in proximity to the patient being monitored if notactually attached to the patient at a measurement site.

As disclosed, the portable patient monitor 102 communicates with the hub100, in an embodiment, through the docking station 106 when docked and,in an embodiment, wirelessly when undocked, however, such undockedcommunication is not required. The hub 100 communicates with one or moremulti-patient monitoring servers 204 or server systems, such as, forexample, those disclosed with in U.S. Pat. Pub. Nos. 2011/0105854,2011/0169644, and 2007/0180140. In general, the server 204 communicateswith caregiver backend systems 206 such as EMR and/or ADT systems. Theserver 204 may advantageously obtain through push, pull or combinationtechnologies patient information entered at patient admission, such asdemographical information, billing information, and the like. The hub100 accesses this information to seamlessly associate the monitoredpatient with the caregiver backend systems 206. Communication betweenthe server 204 and the monitoring hub 100 may be any recognizable to anartisan from the disclosure herein, including wireless, wired, overmobile or other computing networks, or the like.

FIG. 2 also shows the hub 100 communicating through its serial dataports 210 and channel data ports 212. As disclosed in the forgoing, theserial data ports 210 may provide data from a wide variety of patientmedical devices, including electronic patient bed systems 214, infusionpump systems 216 including closed loop control systems, ventilatorsystems 218, blood pressure or other vital sign measurement systems 220,or the like. Similarly, the channel data ports 212 may provide data froma wide variety of patient medical devices, including any of theforegoing, and other medical devices. For example, the channel dataports 212 may receive data from depth of consciousness monitors 222,such as those commercially available from SEDLine, brain or other organoximeter devices 224, noninvasive blood pressure or acoustic devices226, or the like. In an embodiment, channel device may includeboard-in-cable (“BIC”) solutions where the processing algorithms and thesignal processing devices that accomplish those algorithms are mountedto a board housed in a cable or cable connector, which in someembodiments has no additional display technologies. The BIC solutionoutputs its measured parameter data to the channel port 212 to bedisplayed on the display 104 of hub 100. In an embodiment, the hub 100may advantageously be entirely or partially formed as a BIC solutionthat communicates with other systems, such as, for example, tablets,smartphones, or other computing systems.

Although disclosed with reference to a single docking station 106, theenvironment 200 may include stacked docking stations where a subsequentdocking station mechanically and electrically docks to a first dockingstation to change the form factor for a different portable patentmonitor as discussed with reference to FIG. 5. Such stacking may includemore than 2 docking stations, may reduce or increase the form fact formechanical compliance with mating mechanical structures on a portabledevice.

FIG. 3 illustrates a simplified exemplary hardware block diagram of thehub 100 of FIG. 1, according to an embodiment of the disclosure. Asshown in FIG. 3, the housing 108 of the hub 100 positions and/orencompasses an instrument board 302, the display 104, memory 304, andthe various communication connections, including the serial ports 210,the channel ports 212, Ethernet ports 305, nurse call port 306, othercommunication ports 308 including standard USB or the like, and thedocking station interface 310. The instrument board 302 comprises one ormore substrates including communication interconnects, wiring, ports andthe like to enable the communications and functions described herein,including inter-board communications. A core board 312 includes the mainparameter, signal, and other processor(s) and memory, a portable monitorboard (“RIB”) 314 includes patient electrical isolation for the monitor102 and one or more processors, a channel board (“MID”) 316 controls thecommunication with the channel ports 212 including optional patientelectrical isolation and power supply 318, and a radio board 320includes components configured for wireless communications.Additionally, the instrument board 302 may advantageously include one ormore processors and controllers, busses, all manner of communicationconnectivity and electronics, memory, memory readers including EPROMreaders, and other electronics recognizable to an artisan from thedisclosure herein. Each board comprises substrates for positioning andsupport, interconnect for communications, electronic componentsincluding controllers, logic devices, hardware/software combinations andthe like to accomplish the tasks designated above and others.

An artisan will recognize from the disclosure herein that the instrumentboard 302 may comprise a large number of electronic components organizedin a large number of ways. Using different boards such as thosedisclosed above advantageously provides organization andcompartmentalization to the complex system.

FIG. 4 illustrates a perspective view of an exemplary removable dockingstation 400 of the hub 100 of FIG. 1, according to an embodiment of thedisclosure. As shown in FIG. 4, the docking station 400 provides amechanical mating to portable patient monitor 102 to provide securemechanical support when the monitor 102 is docked. The docking station400 includes a cavity 402 shaped similar to the periphery of a housingof the portable monitor 102. The station 400 also includes one or moreelectrical connectors 404 providing communication to the hub 100.Although shown as mounted with bolts, the docking station 400 may snapfit, may use movable tabs or catches, may magnetically attach, or mayemploy a wide variety or combination of attachment mechanisms know to anartisan from the disclosure herein. In an embodiment, the attachment ofthe docking station 400 should be sufficiently secure that when docked,the monitor 102 and docking station cannot be accidentally detached in amanner that could damage the instruments, such as, for example, if thehub 100 was accidently bumped or the like, the monitor 102 and dockingstation 400 should remain intact.

The housing 108 of the hub 100 also includes cavity 406 housing thedocking station 400. To the extent a change to the form factor for theportable patient monitor 102 occurs, the docking station 400 isadvantageously removable and replaceable. Similar to the docking station400, the hub 100 includes within the cavity 406 of the housing 108electrical connectors 408 providing electrical communication to thedocking station 400. In an embodiment, the docking station 400 includesits own microcontroller and processing capabilities, such as thosedisclosed in U.S. Pat. Pub. No. 2002/0140675. In other embodiments, thedocking station 400 passes communications through to the electricalconnector 408.

FIG. 4 also shows the housing 108 including openings for channel ports212 as universal medical connectors discussed in detail below.

FIG. 5 illustrates a perspective view of exemplary portable patientmonitors 502 and 504 undocked from the hub 100 of FIG. 1, according toan embodiment of the disclosure. As shown in FIG. 5, the monitor 502 maybe removed and other monitors, like monitor 504 may be provided. Thedocking station 106 includes an additional docking station 506 thatmechanically mates with the original docking station 106 and presents aform factor mechanically matable with monitor 504. In an embodiment, themonitor 504 mechanically and electrically mates with the stacked dockingstations 506 and 106 of hub 100. As can be readily appreciated by andartisan from the disclosure herein, the stackable function of thedocking stations provides the hub 100 with an extremely flexiblemechanism for charging, communicating, and interfacing with a widevariety of patient monitoring devices. As noted above, the dockingstations may be stacked, or in other embodiments, removed and replaced.

FIG. 6 illustrates a simplified block diagram of traditional patientelectrical isolation principles. As shown in FIG. 6, a host device 602is generally associated with a patient device 604 through communicationand power. As the patient device 604 often comprises electronicsproximate or connected to a patient, such as sensors or the like,certain safety requirements dictate that electrical surges of energyfrom, for example, the power grid connected to the host device, shouldnot find an electrical path to the patient. This is generally referredto a “patient isolation” which is a term known in the art and includesherein the removing of direct uninterrupted electrical paths between thehost device 602 and the patient device 604. Such isolation isaccomplished through, for example, isolation devices 606 on powerconductors 608 and communication conductors 610. Isolation devices 606can include transformers, optical devices that emit and detect opticalenergy, and the like. Use of isolation devices, especially on powerconductors, can be expensive component wise, expensive size wise, anddrain power. Traditionally, the isolation devices were incorporated intothe patient device 604, however, the patient devices 604 are trendingsmaller and smaller and not all devices incorporate isolation.

FIG. 7A illustrates a simplified block diagram of an exemplary optionalpatient isolation system according to an embodiment of the disclosure.As shown in FIG. 7A, the host device 602 communicates with an isolatedpatient device 604 through isolation devices 606. However, a memory 702associated with a particular patient device informs the host 602 whetherthat device needs isolated power. If a patient device 708 does not needisolated power, such as some types of cuffs, infusion pumps,ventilators, or the like, then the host 602 can provide non-isolatedpower through signal path 710. This power may be much higher that whatcan cost-effectively be provided through the isolated power conductor608. In an embodiment, the non-isolated patient devices 708 receiveisolated communication as such communication is typically at lowervoltages and is not cost prohibitive. An artisan will recognize from thedisclosure herein that communication could also be non-isolated. Thus,FIG. 7A shows a patient isolation system 700 that provides optionalpatient isolation between a host 602 and a wide variety of potentialpatient devices 604, 708. In an embodiment, the hub 100 includes thechannel ports 212 incorporating similar optional patient isolationprinciples.

FIG. 7B adds an exemplary optional non-isolation power levels for thesystem of FIG. 7A according to an embodiment of the disclosure. As shownin FIG. 7B, once the host 602 understands that the patient device 604comprises a self-isolated patient device 708, and thus does not needisolated power, the host 602 provides power through a separate conductor710. Because the power is not isolated, the memory 702 may also providepower requirements to the host 602, which may select from two or morevoltage or power levels. In FIG. 7B, the host 602 provides either highpower, such as about 12 volts, but could have a wide range of voltagesor very high power such as about 24 volts or more, but could have a widerange of voltages, to the patient device 708. An artisan will recognizethat supply voltages can advantageously be altered to meet the specificneeds of virtually any device 708 and/or the memory could supplyinformation to the host 602 which provided a wide range of non-isolatedpower to the patient device 708.

Moreover, using the memory 702, the host 602 may determine to simply notenable any unused power supplies, whether that be the isolated power orone or more of the higher voltage non-isolated power supplies, therebyincreasing the efficiency of the host.

FIG. 8 illustrates a simplified exemplary universal medical connectorconfiguration process 800, according to an embodiment of the disclosure.As shown in FIG. 8, the process includes step 802, where a cable isattached to a universal medical connector incorporating optional patientisolation as disclosed in the foregoing. In step 804, the host device602 or the hub 100, more specifically, the channel data board 316 orEPROM reader of the instrument board, reads the data stored in thememory 702 and in step 806, determines whether the connecting devicerequires isolated power. In step 808, when the isolated power isrequired, the hub 100 may advantageously enable isolated power and instep 810, enable isolated communications. In step 806, when isolatedpower is not needed, the hub 100 may simply in optional step 812 enablenon-isolated power and in embodiments where communications remainisolated, step 810 enable isolated communications. In other optionalembodiments, in step 806, when isolated power is not needed, the hub 100in step 814 may use information from memory 702 to determine the amountof power needed for the patient device 708. When sufficient power is notavailable, because for example, other connected devices are also usingconnected power, in step 816 a message may be displayed indicating thesame and power is not provided. When sufficient power is available,optional step 812 may enable non-isolated power. Alternatively, optionalstep 818 may determine whether memory 702 indicates higher or lowerpower is desired. When higher power is desired, the hub 100 may enablehigher power in step 820 and when not, may enable lower power in step822. The hub 100 in step 810 then enables isolated communication. In anembodiment, the hub 100 in step 818 may simply determine how much poweris needed and provide at least sufficient power to the self-isolateddevice 708.

An artisan will recognize from the disclosure herein that hub 100 maynot check to see if sufficient power is available or may provide one,two or many levels of non-isolated voltages based on information fromthe memory 702.

FIGS. 9A and 9B illustrate simplified block diagrams of exemplaryuniversal medical connectors 900 having a size and shape smaller incross section than tradition isolation requirements. In an embodiment,the connector 900 physically separates non-isolated signals on one side910 from isolated signals on another side 920, although the sides couldbe reversed. The gap between such separations may be dictated at leastin part by safety regulations governing patient isolation. In anembodiment, the distance between the sides 910 and 920 may appear to betoo small.

As shown from a different perspective in FIG. 9B, the distance betweenconnectors “x” appears small. However, the gap causes the distance toincludes a non-direct path between conductors. For example, any shortwould have to travel path 904, and the distance of such path is withinor beyond such safety regulations, in that the distance is greater than“x.” It is noteworthy that the non-straight line path 904 occursthroughout the connector, such as, for example, on the board connectorside where solder connects various pins to a PCB board.

FIG. 10 illustrates a perspective view of a side of the hub 100 of FIG.1, showing exemplary instrument-side channel inputs 1000 as exemplaryuniversal medical connectors. As shown in FIG. 10, the inputs includethe non-isolated side 910, the isolated side 920, and the gap. In anembodiment, the memory 710 communicates through pins on the non-isolatedside.

FIGS. 11A-11K illustrate various views of exemplary male and matingfemale universal medical connectors, according to embodiments of thedisclosure. For example, FIGS. 11G1 and 11G2 shows various preferred butnot required sizing, and FIG. 11H shows incorporation of electroniccomponents, such as the memory 702 into the connectors. FIGS. 11I-11Killustrate wiring diagrams and cabling specifics of the cable itself asit connects to the universal medical connectors.

FIG. 12 illustrates a simplified block diagram of a channel system forthe hub of FIG. 1, according to an embodiment of the disclosure. Asshown in FIG. 12, a male cable connector, such as those shown in FIG. 11above, includes a memory such as an EPROM. The memory advantageouslystores information describing the type of data the hub 100 can expect toreceive, and how to receive the same. A controller of the hub 100communicates with the EPROM to negotiate how to receive the data, and ifpossible, how to display the data on display 104, alarm when needed, andthe like. For example, a medical device supplier may contact the hubprovider and receive a software developers' kit (“SDK”) that guides thesupplier through how to describe the type of data output from theirdevice. After working with the SDK, a map, image, or other translationfile may advantageously be loaded into the EPROM, as well as the powerrequirements and isolation requirements discussed above. When thechannel cable is connected to the hub 100 through the channel port 212,the hub 100 reads the EPROM and the controller of the hub 100 negotiateshow to handle incoming data.

FIG. 13 illustrates an exemplary logical channel configuration that maybe stored in the EPROM of FIG. 12. As shown in FIG. 13, each incomingchannel describes one or more parameters. Each parameter describeswhatever the hub 100 should know about the incoming data. For example,the hub 100 may want to know whether the data is streaming data,waveform data, already determined parameter measurement data, ranges onthe data, speed of data delivery, units of the data, steps of the units,colors for display, alarm parameters and thresholds, including complexalgorithms for alarm computations, other events that are parameter valuedriven, combinations of the same or the like. Additionally, theparameter information may include device delay times to assist in datasynchronization or approximations of data synchronization acrossparameters or other data received by the hub 100. In an embodiment, theSDK presents a schema to the device supplier which self-describes thetype and order of incoming data. In an embodiment, the informationadvantageously negotiates with the hub 100 to determine whether to applycompression and/or encryption to the incoming data stream.

Such open architecture advantageously provides device manufacturers theability to port the output of their device into the hub 100 for display,processing, and data management as disclosed in the foregoing. Byimplementation through the cable connector, the device manufactureravoids any reprogramming of their original device; rather, they simplylet the hub 100 know through the cable connector how the alreadyexisting output is formatted. Moreover, by describing the data in alanguage already understood by the hub 100, the hub 100 also avoidssoftware upgrades to accommodate data from “new-to-the-hub” medicaldevices.

FIG. 14 illustrates a simplified exemplary process for configuring achannel according to an embodiment of the disclosure. As shown in FIG.14, the hub provider provides a device manufacturer with an SDK in step1402, who in turn uses the SDK to self-describe the output data channelfrom their device in step 1404. In an embodiment, the SDK is a series ofquestions that guide the development, in other embodiments, the SDKprovides a language and schema to describe the behavior of the data.

Once the device provider describes the data, the hub provider creates abinary image or other file to store in a memory within a cable connectorin step 1405; however, the SDK may create the image and simplycommunicated it to the hub provider. The cable connector is provided asan OEM part to the provider in step 1410, who constructs andmanufactures the cable to mechanically and electrically mate with outputports on their devices in step 1412.

Once a caregiver has the appropriately manufactured cable, with one endmatching the device provider's system and the other OEM'ed to match thehub 100 at its channel ports 212, in step 1452 the caregiver can connectthe hub between the devices. In step 1454, the hub 100 reads the memory,provides isolated or non-isolated power, and the cable controller andthe hub 100 negotiate a protocol or schema for data delivery. In anembodiment, a controller on the cable may negotiated the protocol, in analternative embodiment, the controller of the hub 100 negotiates withother processors on the hub the particular protocol. Once the protocolis set, the hub 100 can use, display and otherwise process the incomingdata stream in an intelligent manner.

Through the use of the universal medical connectors described herein,connection of a myriad of devices to the hub 100 is accomplished throughstraightforward programming of a cable connector as opposed tonecessitating software upgrades to each device.

FIG. 15 illustrates a perspective view of the hub of FIG. 1 including anexemplary attached board-in-cable (“BIC”) to form an input channelaccording to an embodiment of the disclosure. As shown in FIG. 15, aSEDLine depth of consciousness board communicates data from anappropriate patient sensor to the hub 100 for display and caregiverreview. As described, the provider of the board need only use the SDK todescribe their data channel, and the hub 100 understands how to presentthe data to the caregiver.

FIG. 16 illustrates a perspective view of a back side of the hub 100 ofFIG. 1, showing an exemplary serial data inputs. In an embodiment, theinputs include such as RJ 45 ports. As is understood in the art, theseports include a data ports similar to those found on computers, networkrouters, switches and hubs. In an embodiment, a plurality of these portsare used to associate data from various devices with the specificpatient identified in the hub 100. FIG. 16 also shows a speaker, thenurse call connector, the Ethernet connector, the USBs, a powerconnector and a medical grounding lug.

FIG. 17A illustrates an exemplary monitoring environment withcommunication through the serial data connections of the hub 100 of FIG.1, according to an embodiment of the disclosure. As shown and asdiscussed in the foregoing, the hub 100 may use the serial data ports210 to gather data from various devices within the monitoringenvironment, including an electronic bed, infusion pumps, ventilators,vital sign monitors, and the like. The difference between the datareceived from these devices and that received through the channel ports212 is that the hub 100 may not know the format or structure of thisdata. The hub 100 may not display information from this data or use thisdata in calculations or processing. However, porting the data throughthe hub 100 conveniently associates the data with the specificallymonitored patient in the entire chain of caregiver systems, includingthe foregoing server 214 and backend systems 206. In an embodiment, thehub 100 may determine sufficient information about the incoming data toattempt to synchronize it with data from the hub 100.

In FIG. 17B, a control screen may provide information on the type ofdata being received. In an embodiment, a green light next to the dataindicates connection to a device and on which serial input theconnection occurs.

FIG. 18 illustrates a simplified exemplary patient data flow process,according to an embodiment of the disclosure. As shown, once a patientis admitted into the caregiver environment at step 1802, data about thepatient is populated on the caregiver backend systems 206. The server214 may advantageously acquire or receive this information in step 1804,and then make it accessible to the hub 100. When the caregiver at step1806 assigns the hub 100 to the patient, the caregiver simply looks atthe presently available patient data and selects the particular patientbeing currently monitored. The hub 100 at step 1808 then associates themeasurement, monitoring and treatment data it receives and determineswith that patient. The caregiver need not again associate another devicewith the patient so long as that device is communicating through the hub100 by way of (1) the docking station, (2) the universal medicalconnectors, (3) the serial data connectors, or (4) other communicationmechanisms known to an artisan. At step 1810, some or the entirety ofthe received, processed and/or determined data is passed to the serversystems discussed above.

FIGS. 19A-19J illustrate exemplary displays of anatomical graphics forthe portable patient monitor docked with the hub 100 of FIG. 1,according to embodiments of the disclosure. As shown in FIG. 19A, theheart, lungs and respiratory system are shown while the brain is nothighlighted. Thus, a caregiver can readily determine that depth ofconsciousness monitoring or brain oximetry systems are not currentlycommunicating with the hub 100 through the portable patient monitorconnection or the channel data ports. However, it is likely thatacoustic or other respiratory data and cardiac data is beingcommunicated to or measured by the hub 100. Moreover, the caregiver canreadily determine that the hub 100 is not receiving alarming data withrespect to the emphasized body portions. In an embodiment, theemphasized portion may animate to show currently measured behavior or,alternatively, animate in a predetermined fashion.

FIG. 19B shows the addition of a virtual channel showing an indicationof wellness. As shown in FIG. 19B, the indication is positive as it is a“34” on an increasingly severity scale to “100.” The wellness indicationmay also be shaded to show problems. In contrast to FIG. 19B, FIG. 19Cshows a wellness number that is becoming or has become problematic andan alarming heart graphic. Thus, a caregiver responding to a patientalarm on the hub 100 or otherwise on another device or system monitoringor treating the patient can quickly determine that a review of vitalsigns and other parameters relating to heart function is needed todiagnose and/or treat the patient.

FIGS. 19D and 19E show the brain included in the emphasized bodyportions meaning that the hub 100 is receiving data relevant to brainfunctions, such as, for example, depth of sedation data or brainoximetry data. FIG. 19E additionally shows an alarming heart functionsimilar to FIG. 19C.

In FIG. 19F, additional organs, such as the kidneys are being monitored,but the respiratory system is not. In FIG. 19G, an alarming hearfunction is shown, and in FIG. 19H, an alarming circulatory system isbeing shown. FIG. 19I shows the wellness indication along with lungs,heart, brain and kidneys. FIG. 19J shows alarming lungs, heart, andcirculatory system as well as the wellness indication. Moreover, FIG.19J shows a severity contrast, such as, for example, the heart alarmingred for urgent while the circulatory system alarms yellow for caution.An artisan will recognize other color schemes that are appropriate fromthe disclosure herein.

FIGS. 20A-20C illustrate exemplary displays of measurement data showingdata separation and data overlap, respectively, according embodiments ofthe disclosure. FIGS. 21A and 21B illustrate exemplary displays ofmeasurement data also showing data separation and data overlap,respectively, according embodiments of the disclosure.

For example, acoustic data from an acoustic sensor may advantageouslyprovide breath sound data, while the plethysmograph and ECG or othersignals can also be presented in separate waveforms (FIG. 20A, top ofthe screen capture). The monitor may determine any of a variety ofrespiratory parameters of a patient, including respiratory rate,expiratory flow, tidal volume, minute volume, apnea duration, breathsounds, riles, rhonchi, stridor, and changes in breath sounds such asdecreased volume or change in airflow. In addition, in some cases asystem monitors other physiological sounds, such as heart rate to helpwith probe off detection, heart sounds (S1, S2, S3, S4, and murmurs),and change in heart sounds such as normal to murmur or split heartsounds indicating fluid overload.

Providing a visual correlation between multiple physiological signalscan provide a number of valuable benefits where the signals have someobservable physiological correlation. As one example of such acorrelation, changes in morphology (e.g., envelope and/or baseline) ofthe plethysmographic signal can be indicative of patient blood or otherfluid levels. And, these changes can be monitored to detect hypovolemiaor other fluid-level related conditions. A pleth variability index mayprovide an indication of fluid levels, for example. And, changes in themorphology of the plethysmographic signal are correlated to respiration.For example, changes in the envelope and/or baseline of theplethysmographic signal are correlated to breathing. This is at least inpart due to aspects of the human anatomical structure, such as themechanical relationship and interaction between the heart and the lungsduring respiration.

Thus, superimposing a plethysmographic signal and a respiratory signal(FIG. 20B) can give operators an indication of the validity of theplethysmographic signal or signals derived therefrom, such as a plethvariability index. For example, if bursts in the respiration signalindicative of inhalation and exhalation correlate with changes in peaksand valleys of the plethysmographic envelope, this gives monitoringpersonnel a visual indication that the plethysmographic changes areindeed due to respiration, and not some other extraneous factor.Similarly, if the bursts in the respiration signal line up with thepeaks and valleys in the plethysmographic envelope, this providesmonitoring personnel an indication that the bursts in the respirationsignal are due to patient breathing sounds, and not some othernon-targeted sounds (e.g., patient non-breathing sounds or non-patientsounds).

The monitor may also be configured to process the signals and determinewhether there is a threshold level of correlation between the twosignals, or otherwise assess the correlation. However, by additionallyproviding a visual indication of the correlation, such as by showing thesignals superimposed with one another, the display provides operators acontinuous, intuitive and readily observable gauge of the particularphysiological correlation. For example, by viewing the superimposedsignals, users can observe trends in the correlation over time, whichmay not be otherwise ascertainable.

The monitor can visually correlate a variety of other types of signalsinstead of, or in addition to plethysmographic and respiratory signals.For example, FIG. 20C depicts a screen shot of another examplemonitoring display. As shown in the upper right portion of FIG. 20C, thedisplay superimposes a plethysmographic signal, an ECG signal, and arespiration signal. In other configurations, more than three differenttypes of signals may be overlaid onto one another.

In one embodiment, the hub 100 nothing provides an interface throughwhich the user can move the signals together to overlay on one another.For example, the user may be able to drag the respiration signal downonto the plethysmographic signal using a touch screen interface.Conversely, the user may be able to separate the signals, also using thetouch screen interface. In another embodiment, the monitor includes abutton the user can press, or some other user interface allowing theuser to overlay and separate the signals, as desired. FIGS. 21A and 21Bshow similar separation and joining of the signals.

In certain configurations, in addition to providing the visualcorrelation between the plethysmographic signal and the respiratorysignal, the monitor is additionally configured to process therespiratory signal and the plethysmographic signal to determine acorrelation between the two signals. For example, the monitor mayprocess the signals to determine whether the peaks and valleys in thechanges in the envelope and/or baseline of the plethysmographic signalcorrespond to bursts in the respiratory signal. And, in response to thedetermining that there is or is not a threshold level of correlation,the monitor may provide some indication to the user. For example, themonitor may provide a graphical indication (e.g., a change in color ofpleth variability index indicator), an audible alarm, or some otherindication. The monitor may employ one or more envelope detectors orother appropriate signal processing componentry in making thedetermination.

In certain embodiments, the system may further provide an audibleindication of the patient's breathing sounds instead of, or in additionto the graphical indication. For example, the monitor may include aspeaker, or an earpiece (e.g., a wireless earpiece) may be provided tothe monitoring personnel providing an audible output of the patientsounds. Examples of sensors and monitors having such capability aredescribed in U.S. Pat. Pub. No. 2011/0172561 and are incorporated byreference herein.

In addition to the above described benefits, providing both the acousticand plethysmographic signals on the same display in the manner describedcan allow monitoring personnel to more readily detect respiratory pauseevents where there is an absence of breathing, high ambient noise thatcan degrade the acoustic signal, improper sensor placement, etc.

FIGS. 22A-22B illustrate exemplary analog display indicia, according toan embodiment of the disclosure. As shown in FIGS. 22A and 22B, thescreen shots displays health indicators of various physiologicalparameters, in addition to other data. Each health indicator can includean analog indicator and/or a digital indicator. In embodiments where thehealth indicator includes an analog and a digital indicator, the analogand digital indicators can be positioned in any number of formations,such as side-by-side, above, below, transposed, etc. In the illustratedembodiment, the analog indicators are positioned above and to the sidesof the digital indicators. As shown more clearly in FIG. 22B, the analogdisplays may include colored warning sections, dashes indicatingposition on the graph, and digital information designating quantitateinformation form the graph. In FIG. 22B, for example, the pulse rate PRgraph shows that from about 50 to about 140 beats per minute, the graphis either neutral or beginning to be cautionary, whereas outside thosenumbers the graph is colored to indicate a severe condition. Thus, asthe dash moves along the arc, a caregiver can readily see where in therange of acceptable, cautionary, and extreme the current measurementsfall.

Each analog indicator of the health indicator can include a dial thatmoves about an arc based on measured levels of monitored physiologicalparameters. As the measured physiological parameter levels increase thedial can move clockwise, and as the measured physiological parameterlevels decrease, the dial can move counter-clockwise, or vice versa. Inthis way, a user can quickly determine the patient's status by lookingat the analog indicator. For example, if the dial is in the center ofthe arc, the observer can be assured that the current physiologicalparameter measurements are normal, and if the dial is skewed too far tothe left or right, the observer can quickly assess the severity of thephysiological parameter levels and take appropriate action. In otherembodiments, normal parameter measurements can be indicated when thedial is to the right or left, etc.

In some embodiments, the dial can be implemented as a dot, dash, arrow,or the like, and the arc can be implemented as a circle, spiral,pyramid, or other shape, as desired. Furthermore, the entire arc can belit up or only portions of the arc can be lit up based on the currentphysiological parameter measurement level. Furthermore, the arc can turncolors or be highlighted based on the current physiological parameterlevel. For example, as the dial approaches a threshold level, the arcand/or dial can turn from green, to yellow, to red, shine brighter,flash, be enlarged, move to the center of the display, or the like.

Different physiological parameters can have different thresholdsindicating abnormal conditions. For example, some physiologicalparameters may upper a lower threshold levels, while others only have anupper threshold or a lower threshold. Accordingly, each health indicatorcan be adjusted based on the physiological parameter being monitored.For example, the SpO2 health indicator can have a lower threshold thatwhen met activates an alarm, while the respiration rate health indicatorcan have both a lower and upper threshold, and when either is met analarm is activated. The thresholds for each physiological parameter canbe based on typical, expected thresholds and/or user-specifiedthresholds.

The digital indicator can provide a numerical representation of thecurrent levels of the physiological parameter the digital indicator mayindicate an actual level or a normalized level and can also be used toquickly assess the severity of a patient condition. In some embodiments,the display includes multiple health indicators for each monitoredphysiological parameter. In certain embodiments, the display includesfewer health indicators than the number of monitored physiologicalparameters. In such embodiments, the health indicators can cycle betweendifferent monitored physiological parameters.

FIGS. 23A-23F illustrate exemplary displays of measurement data showing,for example, data presentation in FIGS. 23A-23D when a depth ofconsciousness monitor is connected to a channel port of the hub ofFIG. 1. As shown in FIGS. 23A-23C, the hub 100 advantageously roughlybifurcates its display 104 to show various information from the, forexample, SEDLine device, commercially available from Masimo Corp. ofIrvine, Calif. In FIG. 23D, the hub 100 includes an attached PhaseIndevice, commercially available by PHASEIN AB of Sweden, providing, forexample, information about the patient's respiration. The hub 100 alsoincludes the SEDLine information, so the hub 100 has divided the display104 appropriately. In FIG. 23E, temperature and blood pressure sensorscommunicate with the hub of FIG. 1 and the hub 100 creates display realestate appropriate for the same. In FIG. 23F, an acoustic sensor is alsocommunicating with the hub of FIG. 1, as well as the forgoing bloodpressure and temperature sensor. Accordingly, the hub 100 adjust thedisplay real estate to accommodate the data from each attached device.

The term “and/or” herein has its broadest least limiting meaning whichis the disclosure includes A alone, B alone, both A and B together, or Aor B alternatively, but does not require both A and B or require one ofA or one of B. As used herein, the phrase “at least one of” A, B, “and”C should be construed to mean a logical A or B or C, using anon-exclusive logical or.

The term “plethysmograph” includes it ordinary broad meaning known inthe art which includes data responsive to changes in volume within anorgan or whole body (usually resulting from fluctuations in the amountof blood or air it contains).

The following description is merely illustrative in nature and is in noway intended to limit the disclosure, its application, or uses. Forpurposes of clarity, the same reference numbers will be used in thedrawings to identify similar elements. It should be understood thatsteps within a method may be executed in different order withoutaltering the principles of the present disclosure.

As used herein, the term module may refer to, be part of, or include anApplication Specific Integrated Circuit (ASIC); an electronic circuit; acombinational logic circuit; a field programmable gate array (FPGA); aprocessor (shared, dedicated, or group) that executes code; othersuitable components that provide the described functionality; or acombination of some or all of the above, such as in a system-on-chip.The term module may include memory (shared, dedicated, or group) thatstores code executed by the processor.

The term code, as used above, may include software, firmware, and/ormicrocode, and may refer to programs, routines, functions, classes,and/or objects. The term shared, as used above, means that some or allcode from multiple modules may be executed using a single (shared)processor. In addition, some or all code from multiple modules may bestored by a single (shared) memory. The term group, as used above, meansthat some or all code from a single module may be executed using a groupof processors. In addition, some or all code from a single module may bestored using a group of memories.

The apparatuses and methods described herein may be implemented by oneor more computer programs executed by one or more processors. Thecomputer programs include processor-executable instructions that arestored on a non-transitory tangible computer readable medium. Thecomputer programs may also include stored data. Non-limiting examples ofthe non-transitory tangible computer readable medium are nonvolatilememory, magnetic storage, and optical storage. Although the foregoinginvention has been described in terms of certain preferred embodiments,other embodiments will be apparent to those of ordinary skill in the artfrom the disclosure herein. Additionally, other combinations, omissions,substitutions and modifications will be apparent to the skilled artisanin view of the disclosure herein. Accordingly, the present invention isnot intended to be limited by the reaction of the preferred embodiments,but is to be defined by reference to claims.

Additionally, all publications, patents, and patent applicationsmentioned in this specification are herein incorporated by reference tothe same extent as if each individual publication, patent, or patentapplication was specifically and individually indicated to beincorporated by reference.

1. (canceled)
 2. A system for outputting medical data by a medicalmonitoring hub, the system comprising: a first medical device comprisinga processor configured to: receive a physiological signal from aphysiological sensor; calculate first physiological parameter data basedon the physiological signal; and output the first physiologicalparameter data; and a medical monitoring hub configured to: receive adesignation of a patient via a user interface of the medical monitoringhub; receive the first physiological parameter data from the firstmedical device; receive second physiological parameter data from asecond medical device; associate the first physiological parameter dataand the second physiological parameter data with the patient; receive,via a connection to the second medical device, at least measurementsynchronization data specific to the second medical device; determine,based at least in part on the measurement synchronization data, atime-wise synchronization of the first physiological parameter data andthe second physiological parameter data; and output an indication of thepatient and physiological parameter measurements based on the firstphysiological parameter data and the second physiological parameterdata, wherein the physiological parameter measurements are time-wisesynchronized.
 3. The system of claim 2, wherein the indication of thepatient and the physiological parameter measurements are output to anelectronic medical record (EMR) system.
 4. The system of claim 2,wherein the measurement synchronization data is received via an outputcable of the second medical device.
 5. The system of claim 4, whereinthe second physiological parameter data is received via the output cableof the second medical device.
 6. The system of claim 4, wherein themeasurement synchronization data comprises measurement delayinformation.
 7. The system of claim 4, wherein the measurementsynchronization data is received from a memory of the output cable. 8.The system of claim 2, wherein the medical monitoring hub is furtherconfigured to: receive, via the connection to the second medical device,at least configuration data specific to the second medical device; andadjust the second physiological parameter data based on theconfiguration data specific to the second medical device.
 9. The systemof claim 8, wherein the configuration data indicates at least one of:whether the second physiological parameter data is streaming data,whether the second physiological parameter data is waveform data,whether the second physiological parameter data is already determinedparameter measurement data, ranges on the second physiological parameterdata, speed of delivery of the second physiological parameter data,units of the second physiological parameter data, steps of units of thesecond physiological parameter data, colors for display, alarmparameters, alarm thresholds, algorithms for alarm computations, otherevents that are parameter value driven, or device delay times.
 10. Thesystem of claim 9, wherein the configuration data comprises, for each ofa plurality of parameters, a respective set of instructions regardinginterpretation of data provided by the second medical device withrespect to the respective parameters.
 11. The system of claim 10,wherein the configuration data comprises at least one of a map, animage, or a translation file, and wherein the configuration data isgenerated based on a schema and via a software developers' kitassociated with the medical monitoring hub.
 12. The system of claim 8,wherein the medical monitoring hub is further configured to: determineat least one of compression or encryption requirements from theconfiguration data; and establish at least one of compressed orencrypted communications with the second medical device, wherein thesecond physiological parameter data is received via the at least one ofcompressed or encrypted communications.
 13. A medical monitoring hub foroutputting medical data, the medical monitoring hub comprising: one ormore processors configured to execute software instructions to cause themedical monitoring hub to: receive first physiological parameter datafrom a first medical device; receive second physiological parameter datafrom a second medical device; receive a designation of a patient via auser interface of the medical monitoring hub; associate the firstphysiological parameter data and the second physiological parameter datawith the patient; receive, via a connection to the second medicaldevice, at least measurement synchronization data specific to the secondmedical device; determine, based at least in part on the measurementsynchronization data, a time-wise synchronization of the firstphysiological parameter data and the second physiological parameterdata; and output an indication of the patient and physiologicalparameter measurements based on the first physiological parameter dataand the second physiological parameter data, wherein the physiologicalparameter measurements are time-wise synchronized.
 14. The medicalmonitoring hub of claim 13, wherein the indication of the patient andthe physiological parameter measurements are output to an electronicmedical record (EMR) system.
 15. The medical monitoring hub of claim 13,wherein the measurement synchronization data is received from a memoryof an output cable connecting the second medical device to the medicalmonitoring hub.
 16. The medical monitoring hub of claim 13, wherein theone or more processors are further configured to execute softwareinstructions to cause the medical monitoring hub to: receive, via theconnection to the second medical device, at least configuration dataspecific to the second medical device; and adjust the secondphysiological parameter data based on the configuration data specific tothe second medical device, wherein the configuration data indicates atleast one of: whether the second physiological parameter data isstreaming data, whether the second physiological parameter data iswaveform data, whether the second physiological parameter data isalready determined parameter measurement data, ranges on the secondphysiological parameter data, speed of delivery of the secondphysiological parameter data, units of the second physiologicalparameter data, steps of units of the second physiological parameterdata, colors for display, alarm parameters, alarm thresholds, algorithmsfor alarm computations, other events that are parameter value driven, ordevice delay times.
 17. The medical monitoring hub of claim 16, whereinthe configuration data comprises at least one of a map, an image, or atranslation file, and wherein the configuration data is generated basedon a schema and via a software developers' kit associated with themedical monitoring hub.
 18. The medical monitoring hub of claim 17,wherein the configuration data comprises, for each of a plurality ofparameters, a respective set of instructions regarding interpretation ofdata provided by the second medical device with respect to therespective parameters.
 19. The medical monitoring hub of claim 16,wherein the one or more processors are further configured to executesoftware instructions to cause the medical monitoring hub to: determineat least one of compression or encryption requirements from theconfiguration data; and establish at least one of compressed orencrypted communications with the second medical device, wherein thesecond physiological parameter data is received via the at least one ofcompressed or encrypted communications.
 20. A method of outputtingmedical data by a medical monitoring hub, the method comprising: by oneor more processors comprising digital logic circuitry, receiving firstphysiological parameter data from a first medical device; receivingsecond physiological parameter data from a second medical device;receiving a designation of a patient via a user interface of the medicalmonitoring hub; associating the first physiological parameter data andthe second physiological parameter data with the patient; receiving, viaa connection to the second medical device, at least measurementsynchronization data specific to the second medical device; determining,based at least in part on the measurement synchronization data, atime-wise synchronization of the first physiological parameter data andthe second physiological parameter data; and outputting an indication ofthe patient and physiological parameter measurements based on the firstphysiological parameter data and the second physiological parameterdata, wherein the physiological parameter measurements are time-wisesynchronized.
 21. The method of claim 20, wherein the indication of thepatient and the physiological parameter measurements are output to anelectronic medical record (EMR) system.
 22. The method of claim 20,wherein the measurement synchronization data is received from a memoryof an output cable connecting the second medical device to the medicalmonitoring hub.
 23. The method of claim 20 further comprising: by theone or more processors comprising digital logic circuitry, receiving,via the connection to the second medical device, at least configurationdata specific to the second medical device; and adjusting the secondphysiological parameter data based on the configuration data specific tothe second medical device, wherein the configuration data indicates atleast one of: whether the second physiological parameter data isstreaming data, whether the second physiological parameter data iswaveform data, whether the second physiological parameter data isalready determined parameter measurement data, ranges on the secondphysiological parameter data, speed of delivery of the secondphysiological parameter data, units of the second physiologicalparameter data, steps of units of the second physiological parameterdata, colors for display, alarm parameters, alarm thresholds, algorithmsfor alarm computations, other events that are parameter value driven, ordevice delay times.
 24. The method of claim 23, wherein theconfiguration data comprises at least one of a map, an image, or atranslation file, and wherein the configuration data is generated basedon a schema and via a software developers' kit associated with themedical monitoring hub.
 25. The method of claim 24, wherein theconfiguration data comprises, for each of a plurality of parameters, arespective set of instructions regarding interpretation of data providedby the second medical device with respect to the respective parameters.26. The method of claim 23 further comprising: by the one or moreprocessors comprising digital logic circuitry, determining at least oneof compression or encryption requirements from the configuration data;and establishing at least one of compressed or encrypted communicationswith the second medical device, wherein the second physiologicalparameter data is received via the at least one of compressed orencrypted communications.